Efficacy of Albendazole and Short-Course Prednisolone Treatment in Children with One or Two Ring-Enhancing Lesions of Neurocysticercosis: A Randomized Controlled Trial.

Context: Neurocysticercosis is a endemic disease in Nepal causing social and financial burden on society and developmental problem in children. Aims: To determine the efficacy of albendazole plus oral prednisolone in children with 1 or 2 ring-enhancing lesions (by CT) on resolution of lesions and recurrence of seizure. Setting and Design: Randomized controlled open trial. Methods and Materials: Children with 1 or 2 ring-enhancing lesions <20 mm in diameter on computed tomography scan, likely to have Neurocysticercosis, were assigned to treatment & control groups. Children assigned to the treatment group (n = 50) were given 2.0 mg/kg per day prednisolone orally for 5 days plus 15 mg/kg per day albendazole on third day for 28 days. Anti epileptic drugs were given to both groups {including Control group (n = 51)}. Statistical Analysis: The results were analysed with the use of Epi Info version 6.04 and Stata version;7 software. Results: The lesions resolved completely or partially in more children in the treated group compared with the control group (p = .04 & p = 0.03). The proportion of children who had seizures was significantly lower in the treated group compared with the control group at 6 months (10% versus 33%; p = .006) and 12 months (14% versus 38%; p = .003). Conclusion: Albendazole plus Prednisolone increased resolution of lesions on computed tomography scan and reduced the risk of subsequent recurrence of seizures among children with Neurocysticercosis.

Clinico-Radiological Spectrum of Neuronal Migrational Disorders: A Study of Paediatric Patients in the Western Region of Nepal.

Objective: This study was conducted in a tertiary care paediatric hospital to ascertain the spectrum of clinical and radiological features of Neuronal Migrational Disorders in children. The role of inheritance in Neuronal Migrational Disorders is under intense investigation. Studies on Neuronal Migrational Disorders (NMDs) in children from developing countries are lacking. Method: Retrospective analysis of records of diagnosed cases by neuroimaging as Neuronal Migrational Disorders in the Department of Paediatrics. Results: Eighteen Children (2days to 8years age) with different types of neuronal migrational disorder based on neuro-imaging were included. Observed anomalies included Lissencephaly (33.3%), Pachygyria (16.6%), Polymicrogyria (5.5%), Heterotopia (11.1%), Schizencephaly (22.2%) and Hemimegalencephaly (5.5%). Focal Seizure in 5 (27.7%) cases, Generalised Tonic Clonic Seizures in 3 (16.6%) and Myoclonic Seizure in 2 (11.1%) cases were the types of seizure present in 10 (55.5%) patients. Five patients presented with Quadriparesis, two with Hemiplegia and one with Congenital Talipes Equinovarus. All the eighteen patients had some degree of Cognitive Developmental Delay. Conclusion: Lissencephaly is the most common type of Neuronal Migrational Disorder followed by Schizencepahly. Focal Seizure and Quadriparesis were the common manifestations. Family history of similar cases with parental consanguinity in Schizencephaly cases gives a clue to the autosomal recessive mode of inheritance. Family history of similar cases of Schizencephaly without any history of consanguinity indicates an autosomal pattern of inheritance.